MU: Introduction to Determining Medicaid Volume using the OP Software


You can use your OP software to indicate your Medicaid volume based on provider and group for a specified attestation period. The patient volume reporting period may be dependent upon state regulations. To configure this volume count with your OP software, follow the steps below. Each step is a link that will take you to an article describing how to perform each task. These articles also assume that you are already comfortable pasting and using SQL queries into your Database Viewer and exporting the results into a .csv file. 

Note: There is only one level of security in the Database Viewer. That level of security is permission access. A staff member who has access to the Database Viewer can theoretically run any report that contains any data. This includes data concerning medications, diagnoses, lab results, and other sensitive areas of a patient's chart. Therefore, your practice should limit Database Viewer/SQL access only to individuals at your practice who would normally have access to this information. You will need to have the proper access to utilize your OP Database Viewer in order to utilize the SQL codes in this library. See Providing Access in OP Database Viewer Basics for more information.

For brief instructions and an animated image on how to quickly clip and save SQL code, click here.

Note: The Database Viewer accesses the same database as the OP software.  If you run a query that filters a lot of data, your database could become sluggish and affect your users. It is recommended to run queries during hours when users are not running the OP software.

When applying an SQL from the State Group SQL table, you may need a basic understanding on how to create an SQL query.  To learn how to create an SQL query, see our Clip-and-Save SQL: Quickstart! 

Note: The Database Viewer is a powerful tool for aggregating data into a single file, which can prove to be a double-edged sword if placed in the wrong hands. This is even more relevant if your practice does not follow other best practices. For example, a practice may store unencrypted credit card numbers in the Patient Register. That is an ill-advised risk. It is a risk because the Database Viewer makes it very easy to download all of those credit card numbers into a single Excel file if using the proper SQL code. So, please only grant individuals at your practice the use of this powerful tool if they would normally have access to that sensitive information.

Steps to Configure a Report to Indicate your Volume Count

To configure your OP software to accurately report Medicaid results by volume:

  1. Pick a 90-day Medicaid Volume Attestation Period.
  2. Confirm that your Medicaid Designation Plan in your OP software is Correct.
  3. If necessary, correct Assignment of Plans to Medicaid or non-Medicaid Status.
  4. (If your providers practice in multiple locations) Calculate the volume per location.
  5. Determine if your providers will attest as individuals or group.
  6. Select the individual or group attestation Summary SQL associated with your state.
  7. Run the code and save the results. Export, save, and print all results for audit purposes at the time you run them for actual volume validation.